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J Orthop Trauma. 2018 Jun;32(6):301-305. doi: 10.1097/BOT.0000000000001141.

High Rate of Union for Aseptic Distal Tibial Nonunions in Adults Treated With Slow Gradual Compression via Circular External Fixation.

Author information

1
Department of Orthopedic Trauma, University of Texas Health Science Center, Houston, TX.
2
Department of Health and Human Performance, University of Houston, Houston, TX.
3
Center for Problem Fractures and Limb Restoration, Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX.

Abstract

OBJECTIVE:

To evaluate the healing rate of aseptic nonunions of the distal third of the tibia treated with Ilizarov slow gradual compression and deformity correction.

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary referral center.

PATIENTS/PARTICIPANTS:

Ninety-four consecutive adult patients with 94 distal third tibial aseptic nonunions.

INTERVENTION:

Ilizarov external fixation and slow gradual compression; most patients also underwent bone grafting, deformity correction, or both before the initiation of compression.

MAIN OUTCOME MEASUREMENTS:

Rate of bony union.

RESULTS:

Eighty-seven of 94 cases (92.6%) healed after slow gradual compression across the nonunion site with a circular external fixator. Four of the 7 patients who failed treatment healed after additional operative treatment, and the remaining 3 refused further care.

CONCLUSIONS:

Circular external fixation with slow gradual compression was successful in treating aseptic nonunions of the distal third of the tibia in 92.6% of cases. Careful selection of patients for this treatment method can lead to a high success rate with a relatively low rate of major complications.

LEVEL OF EVIDENCE:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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